A Comparison Between Spinal Block, General Anesthesia with Bupivacaine Inguinal Field Block and General Anesthesia with Bupivacaine Instillation for Postoperative Pain Following Inguinal Herniorrhaphy in Adult
Galnade S, Jirachai V, Kengjuturat Y, Leesan U, Nontakote U, Piratana K*, Rachmanee A, Sangiumsak A, Somnat Y
Division of Anesthesiology, Sappasitthiprasong Hospital, Ubonrachathanee 34000
Objective : To compare the postoperative pain following inguinal herniorrhaphy. Methods : Ninety, ASA I-III, aged 17-70 year patients with elective, unilateral, non-recurrent, indirect inguinal hernia undergoing Bassini repair were randomly allocated into3 groups. Group I received spinal anesthesia with 0.5% hyperbaric bupivacaine, group II received general anesthesia together with (SB) 0.25% bupivacaine inguinal field block (GA c BIFB) 20 ml before surgery and group III received general anesthesia with 0.25% bupivacaine instillation (GA c BI) 10 ml after herniorrhaphy before closure of the external fascia. General anesthesia via laryngeal mask airway (LMA) was performed with propofol 1.5-2.5 mg/kg and maintained with N2O / O2 / Sevoflurane. Outcome measurement : Postoperative pain scores (VAS 0-10 cm) were assessed at 0, 1/2, 1, 1 1/2 , 2, 3, 4 , 6, 8, 12 and 24 hours after surgery.Results: Within 24 hours after surgery, average postoperative pain scores (mean VAS) in group I (SB) was 1.91 cm, group II (GA c BIFB) was 1.40cm and group III (GA c BI) was 1.83 cm and postoperative morphine requirement per patient in group I (SB) was 3.77 mg, group II (GA c BI) was 4.40 mg. There was no significant difference between patients who received the three treatment modalities. Conclusion : The three anesthetic techniques for 24 hours postoperative pain control following inguinal herniorrhaphy in adult were no significant difference.
วิสัญญีสาร ปี 2547, October-December ปีที่: 30 ฉบับที่ 4 หน้า
postoperative pain, Inguinal field block, Inguinal herniorrhaphy in adult, Spinal block, Wound instillation